Healthcare Provider Details

I. General information

NPI: 1699538710
Provider Name (Legal Business Name): JULIE ANN SEXTON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2024
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 LAKELAND HILLS BLVD
LAKELAND FL
33805-3065
US

IV. Provider business mailing address

1568 CORDGRASS WAY
LAKELAND FL
33813-2715
US

V. Phone/Fax

Practice location:
  • Phone: 863-680-7190
  • Fax: 866-264-8519
Mailing address:
  • Phone: 559-417-4273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN11030561
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: